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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 48-year-old woman with a known history of hypothyroidism was admitted to the intensive care unit with a diagnosis of thyroid storm secondary to acute thyroid hormone poisoning and the possible hyperfunction of a singular thyroid nodule. Her clinical manifestations included pyrexia, tachycardia, tachypnea, hypertension, RUQ abdominal pain, psychotic behavior, and pharyngitis. She was successfully treated with sodium iodide, PTU, propranolol, antibiotics, and a hypothermia mattress, with her serum T4 level returning to normal range prior to discharge. The patient was discharged 9 days after admission in good medical health with no medication. This article clearly shows that the functions of the endocrine system remain a frontier in today's medicine. With research, perhaps one day we might fully understand the intricate pathophysiology that results in thyroid storm. The potential problem format has been utilized in the development of the nursing care plan to assist the nurse with identifying and defining her patient's problems, as well as directing her assessment and nursing intervention. As more is learned about thyroid storm, nurses should update their knowledge so that they will be prepared to care for the patient with these difficult nursing problems.
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PMID:Thyroid storm--a nursing crisis. 655 51

To facilitate postoperative flatus, Prostaglandin F2 alpha (PGF2 alpha) was given intravenously to 23 patients who underwent urological operations. The patients were 14 males and 6 females aged from 20 to 77 years old. Patients with hypertension or cardiovascular disease were not included. Twelve operations were performed under general anesthesia, and 8 under epidural anesthesia. Thirteen operations were performed for the upper urinary tract or adrenal gland, and 5 were for the lower urinary tract. In 2 cases, the peritoneal cavity was opened and operations were performed on the intestines. PGF2 alpha 2000 micrograms was added to the postoperative drip infusion and administered in 2 to 3 hours. Until the first flatus was recognized, PGF2 alpha was given once a day in the same manner. Twenty-six patients, 10 of whom were given either vagostigmine or pantothen postoperatively, served as the control group. PGF2 alpha accelerated the postoperative flatus by 8.7 hours (mean) compared with the control group, but it was not significant. The onset of flatus was significantly promoted under epidural anesthesia. Gastrointestinal movement tended to be facilitated in the PGF2 alpha group after lower urinary tract surgery and in the patients over 50 years old. Three patients complained of severe abdominal pain as a side effect; and, injection of PGF2 alpha was stopped. In 7 patients, mild stomachache , vascular pain, nausea, vomiting or elevation of blood pressure were observed.
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PMID:[The effect of prostaglandin F2 alpha on the gastrointestinal movement after urological surgery]. 658 61

Cerebral cysticercosis was studied in 131 children. The patients were divided into two groups, confirmed and probable cysticercosis. The clinical picture may be divided into two stages: initial stage of acute invasion and chronic encephalitic stage. Symptoms in the initial stage are headache, vomiting, fever, myalgia, abdominal pain, seizures and psychotic reactions. In the initial stage only cerebral edema can be seen in the computed tomography (CT) scan. In the chronic stage, variability of symptomatology is great, and it is in this phase that cysticerci can be seen in the CT scan. Only 66 out of the 131 patients studied had CT performed. The computed tomographic sequence of parenchymatous brain cysticercosis is described. A feature not previously reported was the presence of transient arterial hypertension due to cerebral cysticercosis found in four cases.
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PMID:Clinical manifestations and sequential computed tomography scans of cerebral cysticercosis in childhood. 661 86

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4

The study was undertaken to focus attention on idiopathic retroperitoneal fibrosis, which may confront any surgeon operating in the abdomen or retroperitoneal area. Eleven patients, six men and five women varying in age from 35 to 76 years, were treated from 1969 to 1983. Two patients gave a history of methysergide and one gave a history of ergotamine ingestion. Two patients had associated aortic aneurysms and two had renal artery stenosis. Symptoms were related to entrapment of retroperitoneal structures, primarily the ureter, vena cava, gonadal veins, the aorta and its branches. Abdominal and costovertebral angle pain, testicular pain and swelling, and renovascular hypertension were the most common symptoms. The most common differential diagnostic problem was retroperitoneal tumor. Intravenous or retrograde pyelography were suggestive of the diagnosis in five patients, ultrasonography in two, and computerized axial tomography in another. Treatment consisted of ureterolysis and intraperitoneal transplantation or omental wrapping of the ureter in five, nephrostomy in two, renal-iliac arterial bypass graft in two, and renal autotransplantation in one. One patient was treated conservatively. Good results were achieved in eight, fair results in two, and one patient died postoperatively. Idiopathic retroperitoneal fibrosis should be kept in mind diagnostically in patients with unexplained abdominal pain and/or retroperitoneal lesions, and the surgeon prepared to employ appropriate operative measures for relief when it is encountered.
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PMID:Idiopathic retroperitoneal fibrosis. A sometime surgical problem. 670 19

A 45-year-old woman had abdominal pain, azotemia, and hypertension. Intravenous pyelography revealed bilateral ureteral compression by extrinsic tumor masses that proved to be neurofibromata by histologic examination. After surgical removal of the tumors, she became normotensive and asymptomatic. In addition, severe medial hypertrophy of veins was seen in the tissue examined. We believe that the latter is most probably related to the neurofibromatosis and is analogous to the hypertrophic arterial changes known to occur in patients with von Recklinghausen's disease.
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PMID:Retroperitoneal neurofibromatosis and venous anomalies. 677 34

The amount of primary care provided at hospitals is increasing, yet little information exists on the relative costs of this form of care. To address this issue, we compared the treatment resources used by internists practicing in hospital-based and free-standing clinics. The study site was the Kaiser-Permanente Medical Care Program, Oregon Region. To control for case mix, the analysis focused on episodes of six specified conditions; upper respiratory infection, urinary tract infection, hypertension, abdominal pain, chest pain, and physical exam. The California Relative Value Schedule was used to define care intensity by summarizing the clinical, laboratory, and radiology services provided. Results indicate that setting exerts little influence on the intensity of primary care for the episodes studied; care of similar intensity is provided in hospital-based and free-standing settings.
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PMID:Effects of hospital-based primary care setting on internists' treatment of primary care episodes. 679 28

The 564 consultations performed by a general medicine consultation service during its first year were analyzed in order to provide a concrete definition of this new academic domain. Of the consultations, 52 percent were for patients on the surgical service. Among these patients, the most common reason for consultation was the preoperative management of chronic illness, specifically, hypertension, diabetes, and angina; 47 percent of such patients had two or more chronic illnesses. The service recommended cancellation of planned surgery in 2 percent and postponement in 9 percent of the 210 patients seen preoperatively. Patients on the psychiatric service accounted for 47 percent of the consultations. In this group, diagnostic issues were the most common reasons for consultation, that is, abdominal pain, dementia, and the suspicion of thyroid disease. Only 12 percent of the patients were seen for prognostic reasons, usually related to the planned use of electroconvulsive therapy or tricyclic antidepressants. The service was evaluated by the referring physicians who rated the service favorably on its "mechanics," as well as on its qualitative performance. However, complaints of triviality were voiced when the average length of the list of recommendations seemed disproportionate to the complexity of the problems. The service was also evaluated by the residents who had provided consultations. From their perspective, the service was more successful in teaching the "art" of consultation than the "science." This experience provides an operational definition of the work facing a general medicine consultation service as well as data useful in focusing future educational programs and research efforts.
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PMID:General medicine consultation. Lessons from a clinical service. 685 76

Sclerosing peritonitis developed in a 56-year-old white man who had been receiving propranolol (320 mg/day) for hypertension and angina pectoris since December 1976. The patient had abdominal pain, loss of weight, pleural effusion, and gastrointestinal hemorrhage. Laparotomy revealed extensive adhesions which were so remarkable that the organs were fixed. Infectious and neoplastic causes of fibrosing peritoneal inflammation were excluded. To my knowledge the development of sclerosing peritonitis with extensive colonic involvement and colonic hemorrhage has been been described previously with therapy with propranolol.
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PMID:Sclerosing peritonitis and propranolol. 697 Jun 57

In a research project undertaken to describe the content of adult primary care, episodes of illness for six common primary care conditions were analyzed: URI (upper respiratory infection, UTI (urinary tract infection), HYP (hypertension), AP (abdominal pain), CP (chest pain), and PE (physical examination). Data from the Kaiser-Permanente Medical Care Program-Oregon Region were used in the project. Episode of the six conditions studied tended to be of brief duration; at least half of the episodes of each condition except hypertension involved only a single medical visit. The physical examination episodes typically involved both laboratory and radiology services, but these services were less frequently used for the other five conditions. Few episodes involved a referral to a consultant physician, the use of sophisticated ancillary procedures, repeat tests, or a hospitalization. If patients had been billed for the episode-related care involved in treating each episode, the average charge incurred (in 1980 dollars) would have bee: URI $38.67, UTI and HY $52.27 each, AP $66.59, CP $46.54, and PE $91.65, excluding the costs of pharmaceuticals. Ancillary services accounted for one-third or more of the costs for each type of episode except URI. The results suggest that cost savings in primary care are likely to depend less on the control of sophisticated medical technology than on efficiently meeting patient-initiated demands for care and on influencing physician-generated ordering of simple ancillary procedures. The results also suggest the utility of analyzing the distinctive demands on the medical care system that are generated by diverse primary care conditions.
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PMID:The content of adult primary care episodes. 705 62


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